Search

All 1358 referrals for barium enemas at Bristol Royal Infirmary in 1981 were studied. The overall diagnostic yield for colonic or distal ileal pathology was 33% with 75 (5.5%) cancers detected. General practitioner requested enemas constituted 25.8% of the total undertaken and their diagnostic yield was equal to hospital outpatient requested enemas. Medical and surgical diagnostic yields were similar for both inpatient and outpatients though the indications varied. Women predominated by 3:2 in all age groups. In the under 40's the yield was low (19.8%) except for inflammatory bowel disease. When related to symptoms the lowest yield was obtained for the investigation of abdominal pain (25%), particularly in women, except in those admitted as inpatients. The clinicians were wrong in diagnosing abdominal or pelvic masses as being of colonic origin in over 50% of cases. It is suggested that yield could be improved by being more selective in patients under 40, more use being made of suitable faecal occult blood testing, and ultrasonic scanning of abdominal masses before barium enema. [ABSTRACT FROM PUBLISHER]

Hyoscine butylbromide (20 mg) given intravenously to 48 patients with normal oesophageal motility significantly reduced oesophageal transit of hard gelatin capsules when swallowed in the erect and supine positions with 15 ml and 60 ml water when compared to an age/sex matched group. Delayed capsule transit and possible failed or slowed drug absorption occurring as a consequence of anti-cholinergic drugs on the oesophagus, constitutes a new drug interaction. [ABSTRACT FROM AUTHOR]

The oesophageal transit time of barium sulphate capsules was measured using X ray fluoroscopy in 20 patients with mitral valve disease and 12 control patients in the erect and supine positions when swallowed with both 15 ml and 60 ml of water. An erect barium swallow was performed, and from a lateral radiograph the area of indentation of the oesophagus caused by the cardiac impression was measured. Left atrial diameter was derived from M mode echocardiography. In 19 patients with mitral valve disease one or more capsules remained in the oesophagus for five minutes and disintegrated there, whereas this occurred in only six control patients. Capsule transit time was significantly slower in the study patients than in the control patients in the supine position with 15 ml water. There was a significant correlation between the area of indentation and mean capsule transit time and supine 15 ml transit time. The area of indentation closely correlated with the left atrial diameter. When capsules were delayed in the oesophagus, this occurred mainly at the level of the left atrial impression in the study patients and at the lower oesophageal sphincter in the control patients. Patients with mitral valve disease are more likely than control patients to have delayed oesophageal transit of capsules because of the anatomical deformity caused by enlargement of the left atrium. [ABSTRACT FROM PUBLISHER]